Evaluation of endoscopic C-13-urea breath test for assessment of Helicobacter pylori eradication

To minimize the inaccuracies of the diagnostic methods for Helicobacter pyl ori infection, we developed a new diagnostic method and called it the endos copic C-13-urea breath test (EUBT). We evaluated the accuracy of EUBT for d etecting this infection and assessing its eradication. EUBT was conducted o n 267 patients with gastroduodenal disease. After the collection of a basel ine breath sample, gastroduodenal endoscopy was performed. A 20-ml aliquot of a solution containing 100 mg of C-13-urea was sprayed over the entire ga stric mucosa via the endoscope. A breath sample was then collected 15 min a fter spraying. The content of (CO2)-C-13 was measured in the breath samples by ratio mass spectrometry. Two biopsy specimens each from the antrum and the middle corpus were obtained for culture and histology. The EUBT cutoff level was 1.4 parts per thousand. The sensitivity and specificity of EUBT f or the diagnosis of H. pylori infection were both 98.2%, and for assessment of the eradication they were 100% and 98.9%, respectively. EUBT is an accu rate method not only for the diagnosis of Ii pylori infection but also for assessment of its eradication.